Crowd pleasing hygiene

26th of January 2015

Mass gatherings to celebrate or mark specific events are a regular feature of 21st century life. However, if the entertainment and enjoyment factor are to be guaranteed for all those participating, the risks to public health need to be considered.

Mike Sullivan, managing director of Gojo Europe, explains why access to hand hygiene is a must at large sporting or public events.

Whether sporting prowess is your particular interest, or music festivals are more your style, there now seems to be an event to cater for everyone. While not wanting to spoil the party for anyone, event organisers must address the very real public health risks that can affect occasions when lots of people meet and spend time in one place. The WHO Europe (World Health Organisation) website dedicates a section to this very issue.

It states: “Mass gatherings – including large sports competitions, and political, religious, cultural and artistic events – draw large crowds. They can be settings for disease outbreaks and other health problems, and may promote unhealthy products and result in unhealthy behaviour. All this can stress the public health system and resources of host countries, and the countries where the visitors return to.”

The WHO’s goal is to make large international events safe from public health risks, and it works with partners and national authorities to help them prepare. A good example of its work are the frequently asked questions (FAQs) WHO prepared for travellers to Poland and the Ukraine for the European Football Championship, EURO 2012. The FAQs covered:

In the guidance about traveller’s diarrhoea the FAQ says that: “Prevention is the best medicine. Good hand and personal hygiene is very important. Wash your hands well after visiting the toilet and before handling or eating food.”

The advice has particular resonance in light of the outbreak of suspected norovirus in the athletes’ village before the 2014 Commonwealth Games opened in Glasgow. It was widely reported 53 workers had contracted what was suspected to be norovirus, with an additional 18 members of the security team also experiencing symptoms such as diarrhoea and vomiting. Luckily none of the athletes or their team officials had reported symptoms.

Gastrointestinal illnesses thrive in many different closed and crowded environments. The effects of outbreaks are wide-ranging – from the personal discomfort of those who contract the virus, to the disruption to normal services caused by having to deal with the consequences of an outbreak, and the subsequent work needed to return things to normal.

According to NHS Choices in the UK: “If you have a sudden episode of vomiting and diarrhoea, it’s likely you have norovirus.” It says that some people also experience symptoms such as high temperature, headaches, painful stomach cramps and aching limbs.

It goes on to state that: “It’s not always possible to avoid getting norovirus, but good hygiene measures can help limit the spreads of the virus.” It offers advice to help stop the virus spreading, including:

• Wash hands frequently and thoroughly with soap and water, particularly after using the toilet and before preparing food

• Don’t share towels and flannels

• Disinfect any surfaces or objects that could be contaminated with the virus

• Wash any items of clothing or bedding that could have become contaminated with the virus, and wash the items separately on a hot wash to ensure that the virus is killed

• Avoid visiting hospitals if you have had the typical symptoms of norovirus in the past 48 hours. Some hospitals may request you do not visit if you’ve had symptoms within the past 72 hours.

Norovirus is more serious and even more easily spread among people who are already ill.

Many of us fondly remember the excitement and euphoria surrounding the London 2012 Olympic and Paralympic Games. According to the Office for National Statistics (ONS) the event attracted 680,000 overseas visitors, and 19,568 athletes competed. When you also take into account the support staff and coaches, representatives of sponsors, and all those much praised ‘Games Makers’ (70,000 volunteers), the numbers of people who gathered in the various venues is mind-boggling.

Many months before the Olympic torch was lit in London, a public health campaign for around 200 countries was prepared by health officials to help safeguard against epidemics of infectious diseases. In its publication: ‘Learning from London 2012 – a practical guide to public health and mass gatherings’, The Health Protection Agency (HPA), now called Public Health England, provided information for all those involved in planning mass gatherings, in particular event organisers and public health organisations. It stressed the importance of three fundamental questions:

• What might happen?

• How will you know if it happens?

• What will you do if it happens?

The report lists various scenarios such as outbreaks of food poisoning and legionella. In the run up to London 2012, media reported that both the HPA and the London Olympics organising committee (Locog) believed that one of the most likely public health risks would be an outbreak of vomiting and diarrhoea in the athlete’s village.

The HPA publication neatly sums up the issues surrounding events that attract large numbers of people: “Mass gatherings are very complex events and often take place across multiple venues and with the close involvement of new agencies such as organising committees and international bodies. This adds complexity to the public health response to incidents, as many additional players will wish to be involved. This makes co-ordination an even more critical aspect of response than is usual.”

I would suggest this makes the communication of ways to reduce the risks, together with the provision of facilities and products to help people make wise health decisions, even more crucial. The headlines made by the Ebola virus disease show how important it is to take preventative measures to address the increasingly complex challenges of the healthcare of populations.

Keeping hygiene products on hand

There are a large number of areas within sports stadia and venues that can be improved by the provision of hand hygiene dispensers and systems. Public spaces such as washrooms, reception/ticket collection areas, restaurants or canteens, can all benefit from the appropriate siting of hand hygiene dispensers. However, ‘behind the scenes’ areas should not be forgotten, so adequate provision should also be made for changing rooms, treatment areas, media hubs and offices for support staff.

While hand washing is vitally important, access to adequate facilities is not always possible, and this is where hand sanitising gel can play a major role. Some modern more advanced gel formulations can demonstrate strong viral efficacy and although this is not an alternative to hand washing, they can offer an interim or additional level of protection.

Free standing or wall-mounted dispensers can be sited throughout large areas, while pump bottles can be placed on tables where eating or drinking will take place. Miniature versions, which can be attached to belt loops or bags, ensure that staff and spectators have protection wherever they are and whenever they need it.

However, simply providing hand hygiene products is not enough. Getting the look and feel right is crucial if event organisers and facility managers are to encourage people to clean their hands regularly. The right dispensing systems play a significant role in encouraging people to develop healthy hand hygiene habits, and dispensers which look good will always be more of a draw for the user.

Technology is helping to make dispensers sleeker and more pleasurable to use, with ‘touch free’ models becoming popular. Similarly, soap and hand gel formulations can combine efficacy with ‘spa-like’ fragrances and colours, enhancing the visitor experience.

Practising good hand hygiene is a simple but effective way to reduce the risk of contracting and/or spreading viruses. By equipping venues and facilities with effective and easy-to-use products, organisers can demonstrate their commitment to safeguarding the personal health and well-being of their passengers and staff.